Surgery pp 1669-1678 | Cite as

Cardiac Replacement Therapy

  • Benjamin C. Sun


The term cardiac replacement therapy until recently was limited only to cardiac transplantation. Indeed, the term only evolved as significant innovations were made in the development and implementation of cardiac assist systems as well as xenotransplantation programs. Long-term implantable left ventricular assist devices (LVADs) are currently in use throughout the world with increasing frequency. In addition, the total artificial heart (TAH) is also making resurgence as a viable therapeutic option. Mechanical circulatory support has evolved from a bridge-to-recovery or bridge-to-transplant therapy to also include destination therapy.


Cardiac Transplantation Ventricular Assist Device Mechanical Circulatory Support Heart Lung Transplant Destination Therapy 
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  1. 1.
    American Heart Association. Heart Disease and Stroke Statistics—2005 Update. Dallas, TX: American Heart Association; 2005.Google Scholar
  2. 2.
    Bennett LE, Keck BM, Hertz MI, Trulock EP, Taylor DO. Worldwide thoracic organ transplantation: a report from the UNOS/ISHLT international registry for thoracic organ transplantation. Clin Transpl 2001;25–40.Google Scholar
  3. 3.
    CONSENSUS Trial Study Group. Effects of enalapril on mortality in severe congestive heart failure. N Engl J Med 1987;316:1429–1435.Google Scholar
  4. 4.
    Cowie MR, Mosterd A, Wood DA, et al. The epidemiology of heart failure. Eur Heart J 1997;18:208–225.PubMedGoogle Scholar
  5. 5.
    United Network for Organ Sharing (UNOS) 2003 Annual Report. US Department of Health and Human Resources.Google Scholar
  6. 6.
    DeBakey ME. Left ventricular bypass pump for cardiac assistance. Clinical experience. Am J Cardiol 1971;27:3–11.PubMedCrossRefGoogle Scholar
  7. 7.
    Cooley DA, Liotta D, Hallman GL, et al. Orthotopic cardiac prosthesis for two staged cardiac replacement. Am J Cardiol 1969;24:723–730.PubMedCrossRefGoogle Scholar
  8. 8.
    DeVries WC, Anderson JL, Joyce LD, et al. Clinical use of the total artificial heart. N Engl J Med 1984;310:273–278.PubMedCrossRefGoogle Scholar
  9. 9.
    Rose EA, Gelijns AC, Moskowitz AJ, et al. of the Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) Study Group. Long-term mechanical left ventricular assistance for end-stage heart failure. N Engl J Med 2001;345:1435–1443.PubMedCrossRefGoogle Scholar
  10. 10.
    Farrar D. Atrial versus ventricular cannulation for bridge to transplantation with the Thoratec VAD system. Presentation at: Cardiovascular Technology and Science meeting; 1992.Google Scholar
  11. 11.
    Piacentino V 3rd, Jones J, Fisher CA, et al. Off-pump technique for insertion of a HeartMate Vented Electric left ventricular assist device. J Thorac Cardiovasc Surg 2004;127:262–264.PubMedCrossRefGoogle Scholar
  12. 12.
    Thoratec VAD System Monograph of Clinical Results. Pleasanton: CA, March 1998.Google Scholar
  13. 13.
    Miller PJ, Billich TJ, LaForge DH, et al. Initial clinical experience with a wearable controller for the Novacor left ventricular assist system. ASAIO J 1994;40:M465–M470.PubMedCrossRefGoogle Scholar
  14. 14.
    Oz MC, Dembitsky W. Personal communication and personal experience.Google Scholar
  15. 15.
    Pennington DG, McBride LR, Miller LW, Swartz MT. Eleven years’ experience with the Pierce-Donachy ventricular assist device. J Heart Lung Transplant 1994;13:803–810.PubMedGoogle Scholar
  16. 16.
    Schmid C, Weyand M, Nabavi DG, et al. Cerebral and systemic embolization during left ventricular support with the Novacor N100 device. Ann Thorac Surg 1998;65:1703–1710.PubMedCrossRefGoogle Scholar
  17. 17.
    Portner PM, Jansen PG, Oyer PE, Wheeldon DR, Ramasamy N. Improved outcomes with an implantable left ventricular assist system: a multicenter study. Ann Thorac Surg 2001;71:205–209.PubMedCrossRefGoogle Scholar
  18. 18.
    McCarthy PM, Smedira NO, Vargo RL, et al. One hundred patients with the HeartMate left ventricular assist device: evolving concepts and technology. J Thorac Cardiovasc Surg 1998;115:904–912.PubMedCrossRefGoogle Scholar
  19. 19.
    Sun B, Catanese K, Spanier T, et al. One hundred long term implantable LVADs: the Columbia Presbyterian interim experience. Ann Thorac Surg 1999;68:688–694.PubMedCrossRefGoogle Scholar
  20. 20.
    McBride LR, Swartz MT, Reedy JE, Miller LW, Pennington DG. Device related infections in patients supported with mechanical circulatory support devices for greater than 30 days. ASAIO Trans 1991;37:M258–M259.PubMedGoogle Scholar
  21. 21.
    Argenziano M, Catanese KA, Moazami N, et al. The influence of infection on survival and successful transplantation in patients with left ventricular assist devices. J Heart Lung Transplant 1997;16:822–831.PubMedGoogle Scholar
  22. 22.
    Holman WL, Park SJ, Long JW, et al., REMATCH Investigators. Infection in permanent circulatory support: experience from the REMATCH trial. J Heart Lung Transplant 2004;23:1359–1365.PubMedCrossRefGoogle Scholar
  23. 23.
    Fischer SA, Trenholme GM, Costanzo MR, Piccione W. Infectious complications in left ventricular assist device recipients. Clin Infect Dis 1997;24:18–23.PubMedGoogle Scholar
  24. 24.
    Umana JP, Ewing D, Sun BC, et al. Use of pedicled muscle flaps successfully manages wound infections in implantable left ventricular assist device (LVAD) patients with a low incidence of device endocarditis [abstract]. J Heart Lung Transplant 1997;16:93.Google Scholar
  25. 25.
    Holman WL. Personal communication.Google Scholar
  26. 26.
    Prendergast TW, Todd BA, Beyer AJ 3rd, et al. Management of left ventricular assist device infection with heart transplantation. Ann Thorac Surg 1997;64:142–147.PubMedCrossRefGoogle Scholar
  27. 27.
    Massad MG, Cook DJ, Schmitt SK, et al. Factors influencing HLA sensitization in implantable LVAD recipients. Ann Thorac Surg 1997;64:1120–1125.PubMedCrossRefGoogle Scholar
  28. 28.
    TCI Investigators and Users Meeting;1997.Google Scholar
  29. 29.
    Spanier T, Oz M, Levin H, et al. Activation of coagulation and fibrinolytic pathways in patients with left ventricular assist devices. J Thorac Cardiovasc Surg 1996;112:1090–1097.PubMedCrossRefGoogle Scholar
  30. 30.
    Spanier T, Oz M, Levin H, et al. Activation of coagulation and fibrinolytic-pathways in patients with left ventricular assist devices. Thorac Cardiovasc Surg 1996;112:1090–1097.CrossRefGoogle Scholar
  31. 31.
    Ankersmit HJ, Tugulea S, Spanier T, et al. Activation-induced T-cell death and immune dysfunction after implantation of left-ventricular assist device. Lancet 1999;354:550–555.PubMedCrossRefGoogle Scholar
  32. 32.
    Itescu S, Schuster M, Burke E, et al. Immunobiologic consequences of assist divices. Cardiol Clin 2003;21:119–133, ix–x.PubMedCrossRefGoogle Scholar
  33. 32a.
    Slaughter MS, Tsui SS, El-Banayosy A, et al. Results of a multicenter clinical trial with the Thoratec Implantable Ventricular Assist Device. J Thorac Cardiovasc Surg 2007; 133(6): 1573–1580. Erratum in: J Thorac Cardiovasc Surg 2007;134 (3):A34.PubMedCrossRefGoogle Scholar
  34. 32b.
    Wheeldon DR, LaForge DH, Lee J, Jansen PG, Jassawalla JS, Portner PM. Novacor left ventricular assist system long-term performance: comparison of clinical experience with demonstrated in vitro reliability. ASAIO J 2002;48(5):546–551.PubMedCrossRefGoogle Scholar
  35. 33.
    Kawahito K, Benkowski R, Ohtsubo S, Noon GP, Nose Y, DeBakey ME. Improved flow straighteners reduce thrombus in the NASA/DeBakey axial flow ventricular assist device. Artif Organs 1997;21:339–343.PubMedGoogle Scholar
  36. 34.
    Mizuguchi K, Damm G, Benkowsky R, et al. Development of an axial flow ventricular assist device: in vitro and in vivo evaluation. Artif Organs 1995;19:653–659.PubMedCrossRefGoogle Scholar
  37. 35.
    Macha M, Litwak P, Yamazaki K, et al. Survival for up to 6 months in calves supported with an implantable axial flow ventricular assist device. ASAIO 1997;43:311–315.Google Scholar
  38. 36.
    Frazier OH, Delgado RM 3rd, Kar B, Patel V, Gregoric ID, Myers TJ. First clinical use of the redesigned HeartMate II left ventricular assist system in the United States: a case report. Tex Heart Inst J 2004;31:157–159.PubMedGoogle Scholar
  39. 37.
    Westaby S, Katsumata T, Evans R, Pigott D, Taggart DP, Jarvik RK. The Jarvik 2000 Oxford system: increasing the scope of mechanical circulatory support. J Thorac Cardiovasc Surg 1997;114:467–474.PubMedCrossRefGoogle Scholar
  40. 38.
    Frazier OH, Shah NA, Myers TJ, Robertson KD, Gregoric ID, Delgado R. Use of the Flowmaker (Jarvik 2000) left ventricular assist device for destination therapy and bridging to transplantation. Cardiology 2004;101:111–116.PubMedCrossRefGoogle Scholar
  41. 39.
    Frazier OH, Shah NA, Myers TJ, Robertson KD, Gregoric ID, Delgado R. Use of the flowmaker (Jarvik 2000) left ventricular assist device for destination therapy and bridging to transplantation. Cardiology 2004;101:111–116.PubMedCrossRefGoogle Scholar
  42. 40.
    Vitali E, Lanfranconi M, Ribera E, et al. Successful experience in bridging patients to heart transplantation with the MicroMed DeBakey ventricular assist device. Ann Thorac Surg 2003;75:1200–1204.PubMedCrossRefGoogle Scholar
  43. 41.
    Myers TJ, Robertson K, Pool T, Shah N, Gregoric I, Frazier OH. Continuous flow pumps and total artificial hearts: management issues. Ann Thorac Surg 2003;75(6 suppl):S79–S85.PubMedCrossRefGoogle Scholar
  44. 42.
    Kawahito K, Damm G, Benkowski R, et al. Ex vivo phase 1 evaluation of the DeBakey/NASA axial flow ventricular assist device. Artif Organs 1996;20:47–52.PubMedCrossRefGoogle Scholar
  45. 42a.
    Hohlweg-Majert B, Gutwald R, Siegenthaler MP, Schmelzeisen R. Implantation of the Jarvik 2000 left-ventricular-assist-device: role of the maxillofacial surgeon. Eur J Cardiothorac Surg 2005;28:337–339.PubMedCrossRefGoogle Scholar
  46. 43.
    Muneretto C, Rabago G Jr, Pavie A, et al. Mechanical circulatory support as a bridge to transplantation: current status of total artificial heart in 1989 and determinants of survival. J Cardiovasc Surg 1990;31:486–491.Google Scholar
  47. 44.
    Lederman DM, Kung RT, McNair DS. Therapeutic potential of implantable replacement hearts. Am J Cardiovasc Drugs 2002;2:297–301.PubMedCrossRefGoogle Scholar
  48. 45.
    Frazier OH, Dowling RD, Gray LA Jr, Shah NA, Pool T, Gregoric I. The total artificial heart: where we stand. Cardiology 2004;101:117–121.PubMedCrossRefGoogle Scholar
  49. 46.
    Copeland JG, Smith RG, Arabia FA, et al, CardioWest Total Artificial Heart Investigators. Cardiac replacement with a total artificial heart as a bridge to transplantation. N Engl J Med 2004;351:859–867.PubMedCrossRefGoogle Scholar
  50. 47.
    Dowling RD, Gray LA Jr, Etoch SW, et al. Initial experience with the AbioCor implantable replacement heart system. J Thorac Cardiovasc Surg 2004;127:131–141.PubMedCrossRefGoogle Scholar
  51. 48.
    Helman DN, Maybaum SW, Morales DL, et al. Recurrent remodeling after ventricular assistance: is long-term myocardial recovery attainable? Ann Thorac Surg 2000;70:1255–1258.PubMedCrossRefGoogle Scholar
  52. 49.
    Farrar DJ, Holman WR, McBride LR, et al. Long-term follow-up of Thoratec ventricular assist device bridge-to-recovery patients successfully removed from support after recovery of ventricular function. J Heart Lung Transplant 2002;21:516–521.PubMedCrossRefGoogle Scholar
  53. 50.
    Pagani FD, DerSimonian H, Zawadzka A, et al. Autologous skeletal myoblasts transplanted to ischemia-damaged myocardium in humans. Histological analysis of cell survival and differentiation. J Am Coll Cardiol 2003;41:879–888.PubMedCrossRefGoogle Scholar
  54. 51.
    Hon JK, Yacoub MH. Bridge to recovery with the use of left ventricular assist device and clenbuterol. Ann Thorac Surg 2003;75(6 suppl):S36–S41.PubMedCrossRefGoogle Scholar
  55. 52.
    Oz MC, Argenziano M, Catanese KA, et al. Bridge experience with long-term implantable left ventricular assist devices. Are they an alternative to transplantation? Circulation 1997;95:1844–1852.PubMedGoogle Scholar
  56. 53.
    DeRose JJ, Argenziano M, Sun BC, Reemtsma K, Oz MC, Rose EA. Implantable left ventricular assist devices: an evolving long-term cardiac replacement therapy. Ann Surg 1997;226:461–468; discussion 468–470.PubMedCrossRefGoogle Scholar
  57. 54.
    Oz MC, Argenziano M, Catanese KA, et al. Bridge experience with long-term implantable left ventricular assist devices. Are they an alternative to transplantation? Circulation 1997;95:1844–1852.PubMedGoogle Scholar
  58. 55.
    DeRose JJ Jr, Umana JP, Argenziano M, et al. Implantable left ventricular assist devices provide an excellent outpatient bridge to transplantation and recovery. J Am Coll Cardiol 1997;30:1773–1777.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Benjamin C. Sun
    • 1
  1. 1.Departments of Cardiac Transplantation and Mechanical Support and SurgeryThe Ohio State University Medical CenterColumbusUSA

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